Article Text
Abstract
Introduction University Malaya Medical Centre is the main teaching hospital of University Malaya and admitted over 45000 inpatients in 2009. Palliative care services have gradually evolved since 2002. Services are currently provided by a team of medical specialists who manage an eight bedded inpatient ward, a hospital inpatient consultation team and weekly outpatient service.
Method The palliative care database was reviewed retrospectively for the year 2010–2011 and basic demographic data, types of referrals, diagnostic categories and outcomes of care were collected and compared with the National Council for Palliative Care (NCPC) Minimum Data Set (MDS) report for the year 2009-2010. Only the hospital consultation and inpatient data is presently held within the database.
Results A total of 856 (new, continuing and re-referred) inpatients were seen by the palliative care service. 44% were male (n=336) and 56% were female (n=428) and there were a considerably greater proportion of patients aged 65-74 compared with the NCPC data. Among new referrals, cancer diagnoses comprised 80% of referrals (n=591) compared with 19% (n=142) non-cancer diagnoses and 10 unrecorded diagnoses (1%). Proportionally more patients with breast cancer (17.6% vs 9%), motor neuron disease (9.8% vs 2%), chronic renal problems (21.8% vs 7%) and other heart/circulatory conditions (21.8% vs 12%) were seen compared with the NCPC MDS. More than half the patients seen by the palliative care team were discharged from hospital.
Discussion The data demonstrates referral patterns and potential areas for further development. The need for more accurate evidence reflecting activity levels, outcomes and quality markers will be valuable in monitoring and planning future services as well as allocating resources in order to best meet the needs of the population. Further research into the local population is yet untapped and presents a huge opportunity for further work.